Radical Prostatectomy

[Shorehousejam]

on the pathology report it states as follows

Excerpt from pathology report:

VIII. SEMINAL VESICLE INVASION: Cannot be assessed

The seminal vessels were removed but pathologists said cannot be assessed

Surgeon, Pathologist and Medical Oncologist we spoke to state because they were shrunk or scarred, changed with hormones and Docetaxel chemotherapy treatment

Has anyone ever had this happen or ever heard of this?

It does make us both anxious as it’s so bazaar that they disappeared literally

We will always wonder if they were removed by accident for research.

The whole report is in my prior post

[Tall_Allen]

Not important. It seems to make you anxious, but for no reason.

[Shorehousejam in reply to Tall_Allen]

It does make me anxious it’s so bazaar that they disappeared literally

[RMontana]

…get a second opinion. They have to store your sample so see if you can get another pathologist to read it. Have you considered that.

[Shorehousejam in reply to RMontana]

This is at Weil Cornell top cancer center pathologist did an addendum, suggested an mri to see if removed, Surgeon Dr Hu top surgeon same location confirms they were removed..Getting second opinions from MSK and Hopkins, Dr. J Epstein

We asked for all tissue to be saved, Weil Cornell instead of being transparent that all surgery tissues are saved for twenty years stuck my tissue with a tissue research bank before my pathology was back…

We had to straighten this out.

No luck with locating seminal vessels and no luck locating seminal vessels under a microscope, it all sounds ridiculous

Bladder neck involvement according to pathologist

There is more but the report is cryptic

[RMontana in reply to Shorehousejam]

That’s unbelievable.…if you have tissue sample of the tumor, consider a number of genomics tests. I like decipher, but there are others. That’s another thing you can do to get more information. It may allow you to make a decision as to how aggressive you should be. Gleason score for me is not enough. You have to have a genomics test in order to determine how aggressive the treatment should be. If they still have tissue sample of the tumor and you haven’t done this you could proceed.

[Shorehousejam in reply to RMontana]

We could have the genomics test and decipher score put in even though prostate was removed? These physicians are not forth coming it seems

[RMontana in reply to Shorehousejam]

Yes from what I understand. All you need is a sample of the tumor tissue. Of course, it’s always better to have the sample immediately after the operation but that doesn’t preclude an old sample from being sent in. Yes, you should be able to get this done as long as you can get a sample of the tumor. The doctor would have to work with decipher to understand what exactly they need in order to run the test. I would recommend decipher. It really will help you calibrate the aggressiveness of the treatment that is required. You could be surprised and have a high Gleason score and yet have a low decipher score which means that your tumor cell type is not very lethal or aggressive. Mine was reversed. I had an average Gleason score, but a whopper of a decipher score. I had to opt for very aggressive treatment. See if you can get this done.

[maggiedrum]

The left side lymph nodes were not accessible during my radical prostatectomy and it was noted that extensive scarring from a previous hernia repair was the reason. I had had the hernia repair in the past. I had zero need to ascribe nefarious reasons as to why they couldn't get to the lymph nodes. It has later turned out that my metastasis to my lymph system was via the left side. So not being able to remove the proximal lymph nodes, which were likely invaded, made it more likely that the cancer would spread from there.

It was just a medical and pathology fact of life. I would agree with Tall_Allen and just let it go. From what you wrote about the answers it didn't sound like the tissue samples "disappeared" at all. The pathologist just couldn't examine the tissue remaining so that they could make a good assessment of the tissue samples. Simple as that.

It's understandable to have strong emotions about everything to do with the cancer. The real issue is what was in the prostate and any other tissues which showed cancer involvement. And, like you said, you will never know. I don't know where my cancer will spread from my lymph system. It would just be an academic answer anyway since knowing won't change any therapy options. My MO expects it to metastasize elsewhere in the coming months, and may already have and it is just not large enough to show on the scans I have had recently.

[j-o-h-n in reply to maggiedrum]

maggiedrum very sensible drum beat indeed...........

j-o-h-n <===<<< Senior management is about to spike my spikes....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 04/08/2023 11:32 PM DST

[maggiedrum]

Good luck to you, j-o-h-n, and everyone else